Interview conducted by April Cashin-Garbutt, BA Hons (Cantab)
How important are genomics tests in enhancing medicine?
Very important, and I think they are becoming more important every day. The more connections that are made between genes, disease and drugs, and the more we continue to understand about those connections, the more critical genetic testing will become in modern medicine.
Please can you give a brief overview of the new cloud-based genomics test ordering service Appistry have launched?
Appistry is involved in the clinical research side as well as driving these tests into the clinic itself. What we started to see on the clinical research side was that so much great work was being done around leveraging genomics and genomic data to help make a diagnosis, develop drugs, screen for disease and target therapies much more accurately.
However, it was obvious that what was reasonable, possible and considered good medicine in the major research institutions was becoming much more advanced than what was being practiced on a day-to-day basis in a regional or community hospital, the environment where most people actually receive their treatment.
For us, the whole CloudDx strategy was about finding a way to bridge that gap and bring more state of the art medicine from these leading research institutions into the clinics and regional hospitals so that more people can benefit from the new approaches to modern medicine.
Which tests does The Appistry CloudDx service currently provide access to?
The tests include a cancer test from PGDx, and cardiomyopathy tests, pulmonary tests and a pediatric hearing loss test, all of which are run through Partners Healthcare. We also offer whole genome and exome sequencing.
Over the coming months, I think there will be a continual expansion of these genetic tests being made available through CloudDx. We are focused on the more comprehensive tests rather than the one-to-five-gene panels that are very targeted and trying to answer a specific question or verify a diagnosis.
We are focused on more comprehensive tests that involve dozens and even hundreds of genes, therefore providing a more comprehensive solution for the physician in terms of being able to screen patients for disease risk and target therapies accurately.
What additional tests do you hope to provide?
If you consider the genetic influence on disease, there is a pretty wide variety of diseases that involve a genomic component in terms of their origin or treatment approach. Whether you consider cancer, heart disease, central nervous system disorders, diabetes or any of the of pediatric illnesses, a genetic element is often involved and we’re hoping to make the community or regional hospital a place where information is available on a variety of genomic tests.
We would like to offer some of the finest tests in the world, tests that will be made accessible and visible to the doctors. For example, the typical oncologist, pathologist, or internist is not usually comprehensively trained in the area of genomics and it’s very difficult for them to take on the information these tests can provide because they don’t really know where to even look for the tests, let alone how to decide which test to order or how the results of that test might be interpreted.
We would like to provide them with a service that makes it clear which tests are available and help them understand why they might order one test over another, for example. We can also assist with any questions regarding the final medical report, what the results mean and how to interpret them in terms of the current therapy approach and whether or not it should be changed.
We can also help them to understand where to look for drugs that might be in the pipeline and where to look for research that might impact their patient. In this way, the doctor’s approach could be extremely targeted, allowing them to get answers to questions that might arise from the medical report.
Also, from the perspective of the regional or community hospital, bulking out the infrastructure to directly support these kinds of tests is a very significant investment in terms of time and money. However, these hospitals are where the vast majority of the patients are seen, so it really is important to find a way to provide these physicians with a structured, accessible program that enables access to the very best medicine as well as assistance in interpreting the information.
How does Appistry’s approach differ to that of other test developers?
Our approach is different because we’re really not trying to be a test developer. I think that other companies are trying to be the test developer. They want to be able to run the wet labs, to build the pipelines, develop the analytics and develop the medicine as well as being able to capture all of that intellectual property all under one roof. That’s difficult to do unless you’re very, very targeted in a disease area and some companies that are trying to develop those tests are indeed becoming experts in their area.
However, what we’re trying to do is work with the very best scientists and the best test developers in a given specific area to make it possible to bring those tests into the community hospitals so they can take advantage of them.
We talk about diagnostics as a service but it’s really a cloud service now that can enable a group of doctors to evaluate the availability of various tests using one common interface and workflow that they know they can depend upon, where they can track the progress of the tests on each of their patients and know that their pathologists are going to send out the right sample to the right lab and get quality results.
We’re less about test development and more about making sure that the right combination of tests is deliverable into this community setting.
I don’t know of any other company that is focused like we are in terms of being that central infrastructure, focused on bridging the gap between great medicine and the day-to-day delivery of healthcare.
What more needs to be done to enable genomics to become a routine part of disease diagnosis and treatment?
I think that bringing CloudDx to market is a great first step. I think we’re making it much easier for community hospitals to be able to participate and the more patients that get involved in thinking about diagnosis, therapy and taking these tests, the more the data will expand, therefore accelerating and improving the knowledge that surrounds these tests.
What are Appistry’s plans for the future?
Our plans for the future are to stay very focused on comprehensive genomics research and the delivery of new capabilities into the clinic. I think what you’ll see from us is continued partnerships on the research side with people like the Broad Institute and the National Institute of Health where we will be helping push the science and expand the medical options available to doctors as well helping to bring the very best of medicine into the lives of individuals.
We’re very focused on trying to provide the right avenue, the right highway, the right infrastructure, the right availability and the right support so that the right information gets to the right doctor in order to make a difference to somebody’s life.
Where can readers find more information?
About Kevin Haar
Kevin Haar has more than 25 years of experience in building teams for rapid growth organizations. Before Appistry, Haar spent 17 years at Rational Software, serving in several strategic positions including senior vice president of worldwide field operations. He played an integral role in transforming the company from a software startup into an industry powerhouse with more than $800 million in annual revenues – resulting in a $2.1 billion acquisition by IBM. Haar held several management positions at HP before joining Rational. He holds a Bachelor of Science in electrical engineering and an MBA from Washington University in St. Louis.